肾结核CT检查的临床意义

目的 探讨CT检查对肾结核患者的临床意义。方法 回顾性分析42例肾结核患者的CT及临床资料（其中16例有IVP结果）。结果 单侧肾结核34例，双侧8例，即患肾共50个。典型CT表现有肾实质内围绕肾盂排列的多个囊状低密度区相邻肾皮质变薄（34／50），肾盂输尿管管壁增厚及管腔扩张积水（22／50），肾实质钙化（8／50）。不典型表现有肾实质内单或多发直径小于1cm左右略低于密度结节（6／50）。30例增强CT扫描示，患肾有不同程度强化，其CT上升值在20－120HU之间。腹腔大量淋巴结钙化者2例；合并肝、脾结核4例；腰椎结核骨质破坏并椎旁肿肿6例；合并后腹壁结核脓肿1例。结论 CT检查不仅可用于肾结核的诊断，同时可明确患肾功能、破坏程度、患肾周围情况以及是否合并腹腔其它脏器结核，为临床提供更多更有价值的参考资料。

Significance of the CT scan in renal tuberculosis

OBJECTIVE: To elucidate the features and clinical significance of CT scan in the diagnosis of renal tuberculosis. METHODS: The CT findings and the clinical characteristics of 42 cases with renal TB were retrospectively analyzed. RESULTS: Unilateral renal TB was found in 34 cases, bilateral in 8 cases. The typical CT features were characterized by one or more cysts surrounding the calyx with thin adjacent cortex (34/50), thickened wall of ureters and calyx, hydronephrosis (22/50) and kidney calcification (8/50). Atypical features presented with single or multiple low density nodes in the renal parenchyma (6/50). 30 patients receiving contrast enhanced CT scan showed that intensified Hu (by 20 approximately 120 HU) in the affected kidney. Multiple lymph nodes calcification in abdomen was found in 2 patients, calcification and low density nodes in spleen and liver in 4 patients, vertebral damage and paravertebral abscess in 6 patients and post-abdominal abscess in 1 patient. CONCLUSION: CT scan examination is not only useful in the diagnosis of renal tuberculosis, but also of significance in assessing the severity of the disease, renal function and the involvement of other organs in the abdomen.